How much info do you give to patient's family members?

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In the hospital setting, how much information do you give out to a patient's family member (re: patient's condition).

For instance, do you tell the family member the results of the pt's CXR if he or she were to ask? What if this family member was the "immediate contact" in the patient's chart? Would you still disclose patient information?

What's going on with the patient? Has the patient given any instructions for this?

I work in pediatrics, so I'd give the parents the results of the Chest XR provided the child was a minor and the parent was their legal guardian. I would not give any information to a family member of an adult without explicit permission to do so. When I worked in the hospital, if I had patients who were 18 or over, I always asked them "is it ok to talk in front of your parents?", "if your mother calls, is it ok to talk to her?" etc. But even then, only vague information was shared. "Jenny is doing ok, she's resting now, she said it was ok if you wanted to come visit later."

Can the patient give consent for you to talk give information to them? If yes, then some information can be shared with them. If the patient is unable to give consent, only the legal decision maker can get information. Just be careful about information given via the telephone or to non-decision maker people whether they are family or not. It is appropriate to say the patient is "stable" or "no changes". If they give you a hard time, quote the privacy policy and refer them to the doctor.

I'm mainly talking about adult patients. What if family members were right by the bedside with the patient?

Ask the family member to step out of the room during rounds or if you have information to discuss that maybe the patient wouldn't want to share. If the patient wants the family member there, he can say "it's ok, she can stay."

I work in OB, and I always tell mom what's happening. If I haven't been standing in the room for hours and some decels make me stand there and stare at the strip for 30-40 min with my hand in her stomach I explain why I flew in there like a bat outta you-know-where, flipped her over, poured LR and threw O2 on her face. Chances are if I flew in there like she's getting a c-section soon or will labor the rest of the way with me in her room constantly and she should know why instead of sitting there scared.

If it's a phone call, I say "I'll transfer your call and let you speak to the pt yourself", in my best professional nurse voice. Then transfer them before they start in on the reasons why they'd rather ask me.
If the pt is confused, I ask who they are. If they're not the POA, I (very nicely) suggest they speak to the pt's family.
I don't give out test results unless I've got an OK from the MD, and the pt is ok with me telling whoever is asking. Where I work the MDs sometimes get squirelly about that sort of thing.
If the family is ugly and insistent, I don't know who's POA and who's not, I'll just say "I haven't seen those results yet". That's usually technically true, because I haven't SEEN any report. I NEVER give out bad news under any circumstances. Call me lily livered, or chicken, but that's the MDs job as far as I'm concerned.
Sometimes it's a balancing act trying to CYA regarding HIPPA, and keeping the customer happy.

After all of the above, I only have to remember that British nurse's voice, giving out info to a fake Queen, to keep me on my toes.

I do not give test results. That is the MD's job. If the pt has already been informed and they have questions I will answer those however I will not give results.

Family is tricky because many have no right to the info. I understand they are concerned so I try to keep them informed of the over all care..I will say their vitals are good, u/o is ok etc etc but I do not go into too much detail re labs, CXR, MRI, CT results etc..If giving information to the family it is ok'd by the pt, I will answer basic questions, say things like I haven't seen the reports and if something is wrong the MD will talk to them etc, or we will continue with the current plan of care re: vent support,antibiotics, pressors etc.. Many don't understand what you tell them anyways and miscommunication or misunderstanding can get the nurse in hot water.